THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

INTRODUCED BY READSHAW, CALTAGIRONE, DONATUCCI, KORTZ, DALEY, MUSTIO, M. O'BRIEN, PASHINSKI AND JOSEPHS, MARCH 4, 2011

REFERRED TO COMMITTEE ON INSURANCE, MARCH 4, 2011  

AN ACT

Amending the act of July 22, 1974 (P.L.589, No.205), entitled

"An act relating to unfair insurance practices; prohibiting

unfair methods of competition and unfair or deceptive acts

and practices; and prescribing remedies and penalties,"

further providing for unfair acts.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1.  Section 5(a) of the act of July 22, 1974

(P.L.589, No.205), known as the Unfair Insurance Practices Act,

is amended by adding a paragraph to read:

Section 5.  Unfair Methods of Competition and Unfair or

Deceptive Acts or Practices Defined.--(a)  "Unfair methods of

competition" and "unfair or deceptive acts or practices" in the

business of insurance means:

* * *

(15)  Knowingly doing any of the following:

(i)  Requiring an insured to obtain ophthalmic services and

products from a vision laboratory or company as a condition of

obtaining the payment for the vision services.

(ii)  Imposing upon an insured who is not utilizing an

ophthalmic service or product from a vision laboratory or

company a copayment fee or other condition not imposed upon

insureds utilizing an ophthalmic service or product from the

vision laboratory or company.

(iii)  Hampering competition in numerous ways, including, but

not limited to:

(A)  restraining providers' ability to compete in the market;

(B)  depriving an insured of the choice associated with free

and open competition in the sale of ophthalmic products;

(C)  suppressing competition based upon quality and service;

and

(D)  reducing the quality and level of care available to an

insured in the purchase of any ophthalmic product or denying or

impairing the right of an insured to determine from where

ophthalmic services or products are made.

(iv)  Creating a preferred class of providers that is not

held to uniform conditions of participation under the same

employer's purchased health care contract, vision care contract

or other health insurance contracts.

(v)  Requiring the purchase of a minimum quantity or minimum

dollar amount of a specified brand of materials in order to

participate as a provider in a vision or other health care plan.

(vi)  Requiring a provider to participate in a vision benefit

plan as a condition of participation in a health care plan.

Section 2.  This act shall take effect in 60 days.